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The market for heroin is a robust one, and 2017 is shaping up to be the best year yet for the gangs and cartels who import and distribute the drug in the United States. The drug is now both inexpensive to make and more addictive, but this more potent heroin is also killing its users.

Bloomberg Businessweek traveled to Cincinnati, which has somehow become the capital of American heroin, to find out why the market is so great, and whether it’s possible to stop the flow of heroin laced with even stronger painkillers.

1. Getting dealers off the streets is like playing whack-a-mole. There’s always someone ready to replace any dealer who goes to prison, dies, or quits.

“Everybody and their mom sells drugs these days,” a Cincinnati cop told a reporter. “There’s always somebody right there to pick back up.”

2. Competition is fierce in areas where heroin is popular. Cops describe dealers who mass-text customers about specials on days when sales are slow, and who throw free samples of their products through car windows along with their phone numbers.

3. Prescription painkillers are harder to get hold of. The peak years of prescription opioid abuse began in the ’90s with the introduction of OxyContin. Abuse began to wane at the beginning of this decade, as states tightened up the laws regulating how opioid painkillers are prescribed and dispensed.

This has cut down on pills entering the illegal market, but means that people who were previously abusing painkillers end up turning to heroin, which is comparatively plentiful and cheap.

4. Synthetic opioids on the underground market mean stronger addictions and more deaths. Fentanyl is a powerful synthetic opioid painkiller with legitimate uses, but it’s also mixed with heroin when a teeny amount can cause a fatal overdose. In California, people were hospitalized and died when pills made from fentanyl masqueraded as the prescription drug Norco.

5. It’s easier to hide a lab than a field of flowers. Traditional heroin is made from poppies, which someone has to grow and harvest. Synthetic opioids don’t mean hiding any farms, since you just need a lab, supplies, and a chemist. Production is easier to hide, and the drugs are powerful.

6. You can expect the problem to get worse once we have domestic labs. Most of the drugs used here now come from China or Mexico, but law enforcement expects to see illegal labs making synthetic opioids here, including fentanyl and the even more powerful large animal tranquilizer carfentanil.

7. Addicts want whatever is the most powerful, even if it’s deadly. If it doesn’t kill them, people come back for more once they’ve had the new synthetic drugs.

“Some addicts want that drug that’s killing everybody, because they want to get high or they hope they die,” one recovering heroin user in Cincinnati told Businessweek.

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